Why Support Groups?
Diane LeMont, Ph.D. & Gaye Andrews, Ph.D.
Before weight-loss surgery, it is normal to be very positive. Most patients, convinced that surgery is the tool needed to finally achieve and maintain a “normal” body weight, say they are “ready.” Lifestyle adjustments and challenges? If there are any they’ll “deal with them!” After surgery patients often find there are more adjustments and challenges than anticipated. These significantly increase stress just at the time their primary way of coping with it – food – has been lost!
Weight-loss surgery is a valuable tool – but it is only a tool. For the best result it is important to utilize the tool well. This requires – at minimum – developing a new relationship with food, learning a multitude of new eating and activity behaviors, coping with new physical experiences, managing a range of intense emotions, and dealing with both the positive and negative reactions of others.
A good surgical-weight-loss support group is designed to help patients navigate the recommended lifestyle adjustments, overcome challenges, and manage any stress experienced. Studies suggest that patients who participate in a weight-loss surgery support group lose more weight and keep it off better than those patients who do not take part in such a group.
Of course, it is important that the support group is actually supportive of success. The wrong type of group can actually help sabotage success. If you find yourself in a group that supports being dishonest with the surgeon/ psychologist/program staff, ignoring the prescribed behaviors (e.g., eating slowly), getting around the immediate consequences of poor eating, (e.g., how to eat high-fat or high-sugar foods without dumping), etc., find a new group. A good group supports constructive behavior. It does so by performing a number of critical functions: it provides hope, belonging, information and/or education, skills training, reality checks, empathy and an opportunity to give to others. Let’s look at each of these functions in turn.
Hope
Hope is the expectation that success is possible, which in itself increases the likelihood of success. Hearing how group members have managed the same challenges helps patients realize they can also manage them.
Belonging
Group participation provides an experience of “fitting in,” of being similar to others in an important and validating way. Sharing experiences with others who know the struggle, believe success is possible, and are encouraging makes the journey easier. Also, when a participant is delighted at his or her progress, it’s great to be able to share that happiness with others who truly understand the depth and meaning of the achievement.
Information and/or education
Group participants can benefit from information and/or education on a variety of topics that affect maximum weight loss and maintenance. These include
lifestyle behaviors such as eating a balance of nutritious foods
eating slowly to satisfaction (not fullness)
learning to discriminate between physical hunger and appetite
developing an appropriate exercise program, etc.
Skills Training
In addition to having a reliable source of information on the physical and psychological aftereffects of weight-loss surgery, the group can enhance knowledge of a multitude of life skills, including
communicating assertively
increasing self-esteem
setting and achieving goals
sustaining focus and motivation
encouraging supportive relationships
practicing positive attitudes
providing approaches to challenges
developing effective stress management techniques
coping with difficult emotions
overcoming fears of failure, etc.
Reality Checks
As important as encouragement and “cheerleading” can be, they are significantly enhanced by honest, reality-based feedback. It is one thing to know what to do, it is quite another to put that knowledge into practice. A good support group will provide benevolently-expressed reality checks. A good group will not allow a participant to remain blind to self-sabotaging behavior. If someone is fooling him or herself about a potentially dangerous pattern, or has a blind spot about some important issue, fellow group participants can be relied upon to gently point out these risky behaviors. The group will encourage the participant to replace self-sabotaging behavior with behavior designed for success.
Empathy
Weight-loss surgery is a valuable tool for significant weight loss but it is not the “easy way out.” Many biological, psychological, and social challenges often need to be overcome. The group emotionally supports patients as they respond to the challenges of implementing the lifestyle behaviors recommended for successful weight loss.
Giving
While receiving support is important, another valuable aspect of a group is the opportunity to give support to others. The opportunity to provide assistance and support to another is something most find gratifying, a boost to self-esteem, and a reinforcement of their own skills.
Conclusion
The best preparation for any difficult undertaking is knowledge. A patient’s surgeon and bariatric program should be the primary source of information about the surgery. A good support group adds the richness of personal experience. Group participants provide a wealth of information, validation, and caring. They not only offer constructive information about the physical and emotional challenges they’ve experienced—and how various attempted solutions have worked for them, they can offer a depth of understanding and compassion that is difficult to get anyplace else.
As a participant meets with his or her support group, it is important to remember that a group is only as good as the participants make it. By participating openly and honestly you can both receive and give valuable support. Sharing challenges helps group participants feel less “alone” in their experience and often results in valuable suggestions for overcoming the challenge. Sharing successes gives participants a chance to celebrate accomplishments and encourage others to believe in their ability to achieve their goals for living a slimmer, healthier, enriched quality of life.